What is APAMSA’S National Cancer Initiative?
Why is it important?
What are the cancers that affect Asian Americans?
General concerns about currently available literature.
How can I be involved?
Resources
Other National Groups of Interest
Works Cited
What is APAMSA’S National Cancer Initiative?
The goal of APAMSA’s National Cancer Initiative (ANCI) is to promote awareness about the common cancers that affect Asian Americans, Native Hawaiians and other Pacific Islanders (AA & NHOPIs).
ANCI is important because the cancer burden among AA & NHOPIs is “unique, unusual, and to a certain extent, unnecessary.” In 2005, Chen published the article Cancer Health Disparities among Asian Americans: what we do and what we need to do through the American Cancer Society. In that seminal article, several points were made that inspired the start of ANCI:
1. “Asians are the only racial/ethnic population to experience cancer as the leading cause of death.”
Cancer is the leading cause of death for Asian Americans in both age categories 25-44 years and 45-64 years, and not just for individuals in latter category which is the case among whites.
2. “Asians experience proportionally more cancers of infectious origin, such as human papillomavirus-induced cervical cancer, hepatitis B virus-induced liver cancer, and H. pylori-induced stomach cancer, than any other racial/ethnic populations.”
3. At the same time, Asians experience increasing numbers of cancers associated with “Westernization.”
For example, colorectal cancer incidence is on the rise among Asian Americans. Asian American women who reside in the U.S. for >10 years have an 80% higher risk for breast cancer compared with more recent immigrants (Ziegler et al., (1993) Migration patterns and breast cancer risk in Asian-American women. Journal of the National Cancer Institute, 85(22): 1819-1827).
4. “To a certain extent, the cancer burden for Asian Americans is unnecessary if barriers to cancer screening, overcoming resistance to physician visits, and culturally competent interventions to reduce smoking, unhealthy diet, and increasing proper exercise can be instituted.”
Unfortunately, AAs are the least likely of all racial/ethnic groups to have seen a physician in the last 12 months and to utilize screening tests. Language and cultural barriers continue to exist.
View the full article at PubMed
What are the cancers that affect Asian Americans?
Based on a review of current literature, ANCI has found the following specific cancers of concern for the AA & NHOPI population:
1. LUNG
Lung cancer is one of the most common cancers worldwide. AA & NHOPI’s are no exception. Lung cancer is the leading cause of cancer deaths among Cambodians, Koreans and Vietneamese (Chen 2005).
2. LIVER
With men and women combined, the incidence of hepatocellular carcinoma among Asians was the highest, nearly double that of white Hispanics (11.0 vs 6.8 per 100,000/y), and more than 4 times higher than that of Caucasians (11.0 vs 2.6 per 100,000/y). (Wong 2008)
Liver cancer continues to affect Asian/Pacific Islander Americans disproportionately, with consistently high incidence rates in most subgroups. Culturally targeted prevention methods are needed to reduce the high rates of liver cancer in this growing population in the U.S. (Chang 2007)
2. CHOLANGIOCARCINOMA
Age-adjusted mortality rates were higher for American Indian/Alaska Natives and Asian/Pacific Islanders compared with other groups. (McLean 2006)
3. STOMACH
Along with liver cancer, stomach cancer continues to be one of the largest disparities in Asian American health.
4. CERVICAL CANCER
Female subgroups of the Pan-Asian population have a disproportionately high rate of cervical cancer: Vietnamese, Thai, Hmong, Korean. Vietnamese women have the highest incidence of cervical cancer (43 per 100,000 females), > 5 times the rate in non-Hispanic white females.
5. PANCREATIC
6. PROSTATE CANCER
Senegalese and Indian men had a higher probability of high stage (T3/T4) disease compared to US men. Gleason grade was significantly higher in Asian Indians compared to other populations. African-Americans, Senegalese, and Asian Indians had a significantly higher probability of metastatic disease compared to European Americans. (Zeigler-Johnson 2008)
7. LEUKEMIA
8. COLON
“Westernization” of diet is associated with increased incidence of colon cancer. Also, the ratio of Asian American to Non-Hispanic White adults age 50 and over who reported they ever had a colonoscopy, sigmoidoscopy, or proctoscopy, or had a fecal occult blood test within the past 2 years was 0.7. (http://minorityhealth.hhs.gov/templates/content.aspx?ID=3055)
9. NASOPHARYNGEAL
Incidence rates of nasopharyngeal carcinoma (NPC) are much higher among Chinese than they are among most other racial/ethnic groups around the world. Despite having higher incidence rates of NPC compared with other groups, Chinese NPC patients in the United States have better overall survival and the same risks of NPC-related mortality compared with other racial/ethnic groups. (Sun 2007)
General concerns about currently available literature on cancers affecting AA & NHOPI’s.
General concerns that arose while reviewing the current literature were the following:
- Many articles still group subgroups into one “Asian” category.
- We need to keep updated with future publications.
- We need to encourage more research and more participation by AA & NHOPI patients.
- There are considerable differences in cancer disparities among “Asian” subgroups.
- Consequently, these subgroup differences have implications in public health measures and delivery of care.
- There continues to be a lack of data for some subgroups, e.g. Hmong, Laotians, Cambodians.
1. Research
Seek and talk with scientists and physicians in your school or local community who are researching the cancers that disparately affect AA & NHOPI population or researching the cancer-related disparities themselves. See how you can contribute.
2. Awareness
Community and patients:
Reach out to the local community through health fairs and/or activity booths.
Provide culturally competent, language-appropriate information for patients.
Physicians:
Inform current and future healthcare workers through workshops or talks.
Equip them with helpful resources.
Check out our “Resources” section below!
3. Conferences
Try to attend national conferences addressing minority health, specific cancers (e.g. National Lung Cancer Partnership), and cancer research.
Network with experts in the field and learn so that you in turn are better equipped to increase awareness.
4. Contact your APAMSA National Cancer Director at cancerdirector@apamsa.org.
We want to help you make a difference!
Pamphlets by Language and Cancer Topic
Breast Cancer Toolkit For APAMSA Chapters
Health Fair Poster Prototype
Other National Groups of Interest
Asian American Network for Cancer Awareness, Research and Training
American Public Health Association
American Association for Cancer Research
Asian American Cancer Support Network
Chen, M.S., Jr., Cancer health disparities among Asian Americans: what we do and what we need to do. Cancer, 2005. 104(12 Suppl): p. 2895-902.
Chang, E.T., et al., The burden of liver cancer in Asians and Pacific Islanders in the Greater San Francisco Bay Area, 1990 through 2004. Cancer, 2007. 109(10): p. 2100-8.
Francois, F., J. Park, and E.J. Bini, Colon pathology detected after a positive screening flexible sigmoidoscopy: a prospective study in an ethnically diverse cohort. Am J Gastroenterol, 2006. 101(4): p. 823-30.
Kem, R. and K.C. Chu, Cambodian cancer incidence rates in California and Washington, 1998-2002. Cancer, 2007. 110(6): p. 1370-5.
McCracken, M., et al., Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA Cancer J Clin, 2007. 57(4): p. 190-205.
McDonnell, D.D., et al., Cancer coverage in a mainstream and Korean American online newspaper: lessons for community intervention. Patient Educ Couns, 2008. 71(3): p. 388-95.
McLean, L. and T. Patel, Racial and ethnic variations in the epidemiology of intrahepatic cholangiocarcinoma in the United States. Liver Int, 2006. 26(9): p. 1047-53.
Miller, B.A., et al., Cancer incidence and mortality patterns among specific Asian and Pacific Islander populations in the U.S. Cancer Causes Control, 2008. 19(3): p. 227-56.
Robbins, A.S., et al., Differences in prognostic factors and survival among white and Asian men with prostate cancer, California, 1995-2004. Cancer, 2007. 110(6): p. 1255-63.
Sun, L.M., et al., Survival differences by race in nasopharyngeal carcinoma. Am J Epidemiol, 2007. 165(3): p. 271-8.
Wong, R. and D.A. Corley, Racial and ethnic variations in hepatocellular carcinoma incidence within the United States. Am J Med, 2008. 121(6): p. 525-31.
Zeigler-Johnson, C.M., et al., Evaluation of prostate cancer characteristics in four populations worldwide. Can J Urol, 2008. 15(3): p. 4056-64.
http://minorityhealth.hhs.gov/templates/content.aspx?ID=3055
